By Brian L. Grant MD

Until reading this interesting Forbes article, I had never heard of the Press Ganey company and their ratings for hospitals and doctors. I am familiar with online ratings such as those on Healthgrades.com.

Ratings are problematic to the degree that they may reflect low sample sizes. Especially when responding is optional, those most likely to rate the quality of their medical care may be patients with complaints. And satisfaction with care may be correlated with important issues like listening, time spent, and other behaviors important to patients.

However, one is not guaranteed the best care from a doctor who has great demeanor and a brusque physician may have great clinical judgment and provide better care and outcome in many situations.

To those physicians who complain that the surveys force bad behaviors on their part, one can only bow one’s head in shame.

Integrity means doing the right thing regardless of whether one is not being watched, or in this case, when one is being watched and scored. If the scores are flawed, so be it. It does not justify over-prescribing or any other actions that do not further the right medical decisions and care.

Nobody ever said that doing the right thing is always easy. But really colleagues, is it that hard to say no to a few extra dollars based upon flawed ratings? Is it really that hard to say no to an administrator trying to tell you how to practice medicine? Is it really that hard, if all else fails, to find another job?

The comments in this online article add more color to this interesting topic.